Organochlorine pollutants and female fertility: a systematic review focusing on in vitro fertilization studies.

The possible adverse effects of organochlorine pollutants (OPs) on human fertility are a matter of concern. Direct evaluation of the effects on female fertility was made possible by the advent of in vitro fertilization (IVF). We conducted a systematic review to assess possible associations between OP levels and selected indicators of female fertility in the context of IVF. After harmonization, OP concentrations per unit of lipid varied considerably, OP concentrations were higher in follicular than in serum and conflicting results were obtained. No significant adverse association between OP concentration and female fertility was observed in some studies. In other reports, there were indications of various degrees of significance that oocyte, embryo quality, and implantation may have been impaired. Thus, this review provides no evidence to support the hypothesis that OPs impair female fertility but insufficient evidence to reject this hypothesis. Our conclusions are limited by the diversity of the protocols used, OPs studied, and the quality of the studies selected. The IVF provides a unique context in which to assess the impact of OPs on female fertility, but it is subject to several limitations. Potential frameworks for future studies are proposed.